Effect of Remote Ischemic Preconditioning on Myocardial Ischemia in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial
Wongthep A, Karunasumetta C*, Tourthong W, Senarak P
Division of Cardiothoracic Surgery, Department of Surgery, Srinagarind Hospital and Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; phone: +66-86-8966522; Email: chananyaka@kku.ac.th
Objective: To determine whether the remote ischemic pre-conditioning (RIPC) reduces myocardial ischemia in patients undergoing elective coronary artery bypass graft (CABG) surgery.
Materials and Methods: The present study was a single-center, triple-blinded, randomized controlled trial. Fifty patients undergoing elective coronary artery bypass graft surgery were assigned to either RIPC or control treatment. Ischemic preconditioning consisted of three cycles of 5-minute of lower limb ischemia and reperfusion (cuff inflation and deflation) after anesthesia induction. Myocardial ischemia was assessed based on serum high-sensitivity cardiac troponin T (hs-cTnT).
Results: There was no significant difference in hs-cTnT levels between the RIPC group and the control group. Furthermore, there were no significant differences in inotropic drug use, acute kidney injury, mechanical ventilation time, hospital stay, or 30-day mortality. However, patients in the RIPC group had a significantly shorter length of stay in the intensive care unit (ICU).
Conclusion: Although RIPC did not reduce myocardial ischemia after CABG surgery, it did decrease the length of patients’ stays in the ICU.
วารสารจดหมายเหตุทางการแพทย์ ปี 2563, January ปีที่: 103 ฉบับที่ 1 หน้า 1-7
Coronary artery bypass graft, Remote ischemic preconditioning, Myocardial ischemia, Troponin